Name: semi-quantitative assessment using [18f]fdg tracer in patients with severe brain injury
Uploaded: 2018-11-09T15:00:00
Description: Watch this Scientific Journal Video about Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury at JoVE.com

提交人希望感谢索森医院的 uchino 医生的所有手术。作者还感谢来自 edanz 集团 (www.edanzediting.com/ac) 的亚当·菲利普斯编辑了这份手稿的草稿。

这项研究是根据机构审查委员会 (第07-01号核准书) 进行的, 并遵守了《赫尔辛基宣言》的原则。患者的法律代表对病历和脑图像的使用获得了知情同意。这项研究是在机构道德委员会 (2017-14) 批准后进行的。该议定书是根据日本核医学学会和欧洲核医学协会的指导方针制定的, 作为参考 15,16。
1. 对参与者的筛选
<ol><li>从患者的法律?...

<ol>
	<li>Godbolt, A. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Disorders+of+consciousness+after+severe+traumatic+brain+injury:+a+Swedish-Icelandic+study+of+incidence,+outcomes+and+implications+for+optimizing+care+pathways.">Disorders of consciousness after severe traumatic brain injury: a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways.</a> Journal of Rehabilitation Medicine. 45 (8), 741-748 (2013).</li><li>Klingshirn, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quality+of+evidence+of+rehabilitation+interventions+in+long-term+care+for+people+with+severe+disorders+of+consciousness+after+brain+injury:+A+systematic+review.">Quality of evidence of rehabilitation interventions in long-term care for people with severe disorders of consciousness after brain injury: A systematic review.</a> Journal of Rehabilitation Medicine. 47 (7), 577-585 (2015).</li><li>Fischer, D. B., Truog, R. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+a+reflex?+A+guide+for+understanding+disorders+of+consciousness.">What is a reflex? A guide for understanding disorders of consciousness.</a> Neurology. 85 (6), 543-548 (2015).</li><li>Klingshirn, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=RECAPDOC+-+a+questionnaire+for+the+documentation+of+rehabilitation+care+utilization+in+individuals+with+disorders+of+consciousness+in+long-term+care+in+Germany:+development+and+pretesting.">RECAPDOC - a questionnaire for the documentation of rehabilitation care utilization in individuals with disorders of consciousness in long-term care in Germany: development and pretesting.</a> BMC Health Services Research. 18 (1), 329 (2018).</li><li>St&#233;fan, A., Math&#233;, J. 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P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+semi-automated+workflow+solution+for+multimodal+neuroimaging:+application+to+patients+with+traumatic+brain+injury.">A semi-automated workflow solution for multimodal neuroimaging: application to patients with traumatic brain injury.</a> Brain Informatics. 3 (1), 1-15 (2016).</li><li>Chennu, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brain+networks+predict+metabolism,+diagnosis+and+prognosis+at+the+bedside+in+disorders+of+consciousness.">Brain networks predict metabolism, diagnosis and prognosis at the bedside in disorders of consciousness.</a> Brain. 140 (8), 2120-2132 (2017).</li><li>Di Perri, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neural+correlates+of+consciousnes+s+in+patients+who+have+emerged+from+a+minimally+conscious+state:+a+cross-sectional+multimodal+imaging+study.">Neural correlates of consciousnes s in patients who have emerged from a minimally conscious state: a cross-sectional multimodal imaging study.</a> The Lancet Neurology. 15 (8), 830-842 (2016).</li><li>Ereci&#324;ska, M., Silver, I. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ATP+and+brain+function.">ATP and brain function.</a> Journal of Cerebral Blood Flow &amp; Metabolism. 9 (1), 2-19 (1989).</li><li>Lundgaard, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Direct+neuronal+glucose+uptake+heralds+activity-dependent+increases+in+cerebral+metabolism.">Direct neuronal glucose uptake heralds activity-dependent increases in cerebral metabolism.</a> Nature Communications. 6, 6807 (2015).</li><li>Byrnes, K. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=FDG-PET+imaging+in+mild+traumatic+brain+injury:+a+critical+review.">FDG-PET imaging in mild traumatic brain injury: a critical review.</a> Frontiers in Neuroenergetics. 5, 13 (2014).</li><li>Mortensen, K. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impact+of+Global+Mean+Normalization+on+Regional.">Impact of Global Mean Normalization on Regional.</a> Glucose Metabolism in the Human Brain. Neural Plasticity. , 6120925 (2018).</li><li>Wagatsuma, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+between+new-generation+SiPM-based+and+conventional+PMT-based+TOF-PET/CT.">Comparison between new-generation SiPM-based and conventional PMT-based TOF-PET/CT.</a> Physica Medica. 42, 203-210 (2017).</li><li>Fukukita, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Japanese+guideline+for+the+oncology+FDG-PET/CT+data+acquisition+protocol:+synopsis+of+Version+2.0.">Japanese guideline for the oncology FDG-PET/CT data acquisition protocol: synopsis of Version 2.0.</a> Annals of Nuclear Medicine. 28 (7), 693-705 (2014).</li><li>Varrone, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=EANM+procedure+guidelines+for+PET+brain+imaging+using+[18F]FDG,+version+2.">EANM procedure guidelines for PET brain imaging using [18F]FDG, version 2.</a> European Journal of Nuclear Medicine and Molecular Imaging. 36 (12), 2103-2110 (2009).</li><li>Teasdale, G., Jennett, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+coma+and+impaired+consciousness.+A+practical+scale.">Assessment of coma and impaired consciousness. A practical scale.</a> The Lancet. 2 (7872), 81-84 (1974).</li><li>Valadka, A. B., Moore, E. J., Feliciano, D. V., Moore, E. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Injury+to+the+cranium.">Injury to the cranium.</a> Trauma. , 377-399 (2000).</li><li>Carney, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidelines+for+the+Management+of+Severe+Traumatic+Brain+Injury,+Fourth+Edition.">Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition.</a> Neurosurgery. 80 (1), 6-15 (2017).</li><li>Giacino, J. T., Kalmar, K., Whyte, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+JFK+Coma+Recovery+Scale-Revised:+measurement+characteristics+and+diagnostic+utility.">The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.</a> Archives of Physical Medicine and Rehabilitation. 85 (12), 2020-2029 (2004).</li><li>Schnakers, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Nociception+Coma+Scale:+a+new+tool+to+assess+nociception+in+disorders+of+consciousness.">The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness.</a> Pain. 148 (2), 215-219 (2010).</li><li>Shiel, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Wessex+Head+Injury+Matrix+(WHIM)+main+scale:+a+preliminary+report+on+a+scale+to+assess+and+monitor+patient+recovery+after+severe+head+injury.">The Wessex Head Injury Matrix (WHIM) main scale: a preliminary report on a scale to assess and monitor patient recovery after severe head injury.</a> Clinical Rehabilitation. 14 (4), 408-416 (2000).</li><li>GE Healthcare. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> TRACERlabMXFDG operator manual, Version 1. , (2003).</li><li>Yamaki, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Association+between+uncooperativeness+and+the+glucose+metabolism+of+patients+with+chronic+behavioral+disorders+after+severe+traumatic+brain+injury:+a+cross-sectional+retrospective+study.">Association between uncooperativeness and the glucose metabolism of patients with chronic behavioral disorders after severe traumatic brain injury: a cross-sectional retrospective study.</a> BioPsychoSocial Medicine. 12, 6 (2018).</li><li>Schwaiger, M., Wester, H. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+many+PET+tracers+do+we+need?.">How many PET tracers do we need?.</a> Journal of Nuclear Medicine. 52, (2011).</li></ol>

该协议提供了在一个机构中使用自生成的 [18f] fdg 示踪剂与 [18f] fdg-etpct 进行一系列脑葡萄糖代谢评估的方法。
[18f] fdg 示踪剂的生产遵循 fdg 合成器操作手册中描述的程序;然而, 谨慎对待三点是必要的。首先, 轰炸时间和能量 (步骤 2.5) 应根据患者人数进行调整。其次, 应注意 4, 7, 13, 16, 21, 24-己 aoxa-1, 10 diazabicyclo[8.8.8]hexacosane 的管, 因为它可以很容易地?...

stbi 患者在康复过程中会出现不可预见的神经困难, 包括运动缺陷、感官缺陷和精神不稳定1。虽然临床评估通常是口头进行的, 但 stbi 患者如无反应的清醒综合征或最低意识状态的患者在了解他们是否准确表达自己的想法和情绪方面有特别的困难由于意识障碍, 大脑功能紊乱, 和言语干扰2,3。家庭成员、医务人员和照顾者有时会被不可预见的神经变化或由于沟通能力不足而导致的缺乏反应所迷惑。
近年来, 多模态脑成像被用于探索区域脑功能6、7、8、9。大脑是葡萄糖衍生能量的主要消耗者, 葡萄糖代谢提供了大约95% 的三磷酸腺苷 (atp), 大脑功能10。[18f]-氟脱氧葡萄糖 (fdg) 的摄取是脑组织摄取葡萄糖的标志物。[18楼]fdg-pet/ct 可以检测 [18f] fdg 的吸收, 因此是检查大脑功能11的有用工具.一般情况下, [18f] fdg 图像分析分为两类: roi 分析和基于体素的分析 (vba)12。此前的报告显示, 投资回报率分析是研究创伤特定区域的首选。这是因为 vba (如统计参数映射 [spm]) 需要对标准大脑进行协同和归一化, 而 tbi 由于脑组织变形 (如脑组织萎缩、肿胀、扩大和收缩) 而无法很好地工作。心室空间7,12。虽然已经开发了各种算法和软件来分析磁共振成像 (mri) 数据, 但神经外科和整形外科中使用的金属会产生噪音文物7,12,13.近年来, 利用光电倍增器与 pet/ct 装置, 提高了 petct 衍生脑图像14的空间分辨率。目前的协议侧重于在 stbi 患者中使用自生成的 [18f] fdg 示踪剂,通过[18f] fdg-petct 中的 roi 分析对葡萄糖摄入量进行半定量测量。

<table>
	<tbody>
		<tr>
			<td>20ml syringe</td>
			<td>Terumo</td>
			<td>SS-20ESZ</td>
			<td></td>
		</tr>
		<tr>
			<td>10ml syringe</td>
			<td>Terumo</td>
			<td>SS-10ESZ</td>
			<td></td>
		</tr>
		<tr>
			<td>1ml syringe</td>
			<td>Terumo</td>
			<td>SS-01T</td>
			<td></td>
		</tr>
		<tr>
			<td>Protective plug</td>
			<td>Top</td>
			<td>ML-KS</td>
			<td></td>
		</tr>
		<tr>
			<td>Three-way cock L type 180&#176;</td>
			<td>Terumo</td>
			<td>TS-TL2K</td>
			<td></td>
		</tr>
		<tr>
			<td>Extension tube</td>
			<td>Top</td>
			<td>X1-50</td>
			<td></td>
		</tr>
		<tr>
			<td>Indwelling needle 22G or 24G</td>
			<td>Terumo</td>
			<td>SR-OT2225C</td>
			<td></td>
		</tr>
		<tr>
			<td>Tegaderm transparent dressing</td>
			<td>3M</td>
			<td>1624W</td>
			<td></td>
		</tr>
		<tr>
			<td>Hepaflash 10U/ml 10ml</td>
			<td>Terumo</td>
			<td>PF-10HF10UA</td>
			<td></td>
		</tr>
		<tr>
			<td>Auto dispensing and injection system</td>
			<td>Universal Giken Co., Ltd.</td>
			<td>UG-01</td>
			<td></td>
		</tr>
		<tr>
			<td>Fluid for auto dispensing and injection system</td>
			<td>Universal Giken Co., Ltd.</td>
			<td>UG-01-001</td>
			<td></td>
		</tr>
		<tr>
			<td>Millex-GS Syringe Filter Unit</td>
			<td>Millipore</td>
			<td>SLGSV255F</td>
			<td></td>
		</tr>
		<tr>
			<td>Air needle</td>
			<td>Terumo</td>
			<td>XX-MFA2038</td>
			<td></td>
		</tr>
		<tr>
			<td>Check valve</td>
			<td>Hakko</td>
			<td>23310100</td>
			<td></td>
		</tr>
		<tr>
			<td>Saline 500ml</td>
			<td>HIKARI pharmaceutical Co., Ltd.</td>
			<td>18610155-3</td>
			<td></td>
		</tr>
		<tr>
			<td>Yukiban 25x7mm</td>
			<td>Nitto</td>
			<td>3252</td>
			<td></td>
		</tr>
		<tr>
			<td>Elascot No.3</td>
			<td>Alcare</td>
			<td>44903221</td>
			<td></td>
		</tr>
		<tr>
			<td>Presnet No.3 27x20mm</td>
			<td>Alcare</td>
			<td>11674</td>
			<td></td>
		</tr>
		<tr>
			<td>Steri Cotto a 4x4cm</td>
			<td>Kawamoto</td>
			<td>023-720220-00</td>
			<td></td>
		</tr>
		<tr>
			<td>StatstripXp3</td>
			<td>Nova Biomedical</td>
			<td>11-110</td>
			<td></td>
		</tr>
		<tr>
			<td>Statstrip Glucose strips</td>
			<td>Nova Biomedical</td>
			<td>11-106</td>
			<td></td>
		</tr>
		<tr>
			<td>JMSsheet</td>
			<td>JMS</td>
			<td>JN-SW3X</td>
			<td></td>
		</tr>
		<tr>
			<td>Injection pad</td>
			<td>Nichiban</td>
			<td>No.30-N</td>
			<td></td>
		</tr>
		<tr>
			<td>Stepty</td>
			<td>Nichiban</td>
			<td>No.80</td>
			<td></td>
		</tr>
		<tr>
			<td>Advantage Workstation</td>
			<td>GE Healthcare</td>
			<td>Volume Share 7. version 4.7</td>
			<td></td>
		</tr>
		<tr>
			<td>Discovery MI PET/CT</td>
			<td>GE Healthcare</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>EV Insite</td>
			<td>PSP</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>GE TRACERlab MXFDG synthesizer reagent kit</td>
			<td>ABX</td>
			<td>K-105TM</td>
			<td></td>
		</tr>
		<tr>
			<td>TRACERlab MXFDG cassette</td>
			<td>GE Healthcare</td>
			<td>P5150ME</td>
			<td></td>
		</tr>
		<tr>
			<td>Extension tube</td>
			<td>Universal Giken Co., Ltd</td>
			<td>AT511-ST-001</td>
			<td></td>
		</tr>
		<tr>
			<td>TSK sterilized injection needle 18x100</td>
			<td>Tochigiseiko</td>
			<td>AT511-ST-004</td>
			<td></td>
		</tr>
		<tr>
			<td>TSK sterilized injection needle 18x60</td>
			<td>Tochigiseiko</td>
			<td>AT511-ST-002</td>
			<td></td>
		</tr>
		<tr>
			<td>TSK sterilized injection needle 21x65</td>
			<td>Tochigiseiko</td>
			<td>AT511-ST-003</td>
			<td></td>
		</tr>
		<tr>
			<td>Seal sterile vial -N 5ml</td>
			<td>Mita Rika Kogyo Co., Ltd.</td>
			<td>SSVN5CBFA</td>
			<td></td>
		</tr>
		<tr>
			<td>k222 TLC plate</td>
			<td>Universal Giken Co., Ltd.</td>
			<td>AT511-01-005</td>
			<td></td>
		</tr>
		<tr>
			<td>Anion-cation test paper</td>
			<td>Toyo Roshi Kaisha</td>
			<td>7030010</td>
			<td></td>
		</tr>
		<tr>
			<td>Endospecy ES-24S set</td>
			<td>Seikagaku corporation</td>
			<td>20170</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile evacuated vial</td>
			<td>Gi phama</td>
			<td>10214</td>
			<td></td>
		</tr>
		<tr>
			<td>5ml syringe</td>
			<td>Terumo</td>
			<td>SS-05SZ</td>
			<td></td>
		</tr>
		<tr>
			<td>Extension tube</td>
			<td>Top</td>
			<td>X-120</td>
			<td></td>
		</tr>
		<tr>
			<td>Finefilter F</td>
			<td>Forte grow medical Co.Ltd.</td>
			<td>F162</td>
			<td></td>
		</tr>
		<tr>
			<td>Millex FG</td>
			<td>Merck</td>
			<td>SLFG I25 LS</td>
			<td></td>
		</tr>
		<tr>
			<td>Vented Millex GS</td>
			<td>Merck</td>
			<td>SLGS V25 5F</td>
			<td></td>
		</tr>
		<tr>
			<td>Injection needle 18x38</td>
			<td>Terumo</td>
			<td>NN-1838R</td>
			<td></td>
		</tr>
		<tr>
			<td>Injection needle 21x38</td>
			<td>Terumo</td>
			<td>NN-2138R</td>
			<td></td>
		</tr>
		<tr>
			<td>Water-18O</td>
			<td>Taiyo Nippon Sanso</td>
			<td>F03-0027</td>
			<td></td>
		</tr>
		<tr>
			<td>Distilled water</td>
			<td>Otsuka phrmaceutical</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Hydrogen gas G1</td>
			<td>Hosi Iryou Sanki</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Helium gas G1</td>
			<td>Hosi Iryou Sanki</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Nitrogen G1</td>
			<td>Hosi Iryou Sanki</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>TRACERlabMXFDG</td>
			<td>GE Healthcare</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sep-Pak Light Accell Plus QMA</td>
			<td>WATERS</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sep-Pak Plus tC18</td>
			<td>WATERS</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sep-Pak Plus Alumina N</td>
			<td>WATERS</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>HPLC with 3.9 X 300 mm columns</td>
			<td>WATERS</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>US-2000</td>
			<td>Universal Giken CO. Ltd.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Kryptofix222</td>
			<td>Merck</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>EG Reader SV-12</td>
			<td>Seikagaku Corporation</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>UG-01</td>
			<td>Universal Giken Co., Ltd.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>syngo.via</td>
			<td>Siemens Healthineers</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Advantage Workstation Volume Share 7, version 4.7</td>
			<td>GE Healthcare</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Q clear</td>
			<td>GE Healthcare</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>CRC-15PET dose calibrator</td>
			<td>CAPINTEC, INC.</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

semi-quantitative assessment using [18f]fdg tracer in patients with severe brain injury

严重创伤性脑损伤 (stbi) 患者很难知道他们是否准确地表达自己的想法和情绪, 因为意识障碍, 大脑功能紊乱, 和语言障碍。由于沟通能力不足, 需要对家庭成员、医务人员和照顾者进行客观评价。其中一个评估是对大脑功能区域的评估。近年来, 多模态脑成像被用来探索受损大脑区域的功能。[18f]-氟脱氧葡萄糖正电子发射断层扫描断层扫描 ([18f] fdg-pet/ct) 是检查大脑功能的成功工具。然而, 基于 [18f] fdg-pet变 ct 的脑葡萄糖代谢评估没有标准化, 取决于几个不同的参数, 以及患者的情况。在这里, 我们描述了一系列半定量的评估协议, 用于使用 stbi 患者中自行生成的 [18 f] fdg 跟踪器进行感兴趣区域 (roi) 图像分析。该协议的重点是筛选参与者, 准备 [18f] fdg 跟踪器在热实验室, 安排获取 [18f] fdg-pet变 ct 脑图像, 并使用来自目标大脑区域的 roi 分析测量葡萄糖代谢。

一名 6 3岁的男子在骑自行车时被汽车撞倒,经救护车被送往急诊室。检查显示格拉斯哥昏迷量表得分为 7 (开眼 = 1, 最佳言语反应 = 2, 最佳运动反应 = 4), 厌食症 (右: 2 毫米, 左: 3 毫米), 和负角膜反应17。头部 ct 显示蛛网膜下腔和颅内出血, 左合子、颞骨和顶骨颅骨骨折。病人没有病史, 管理保守。9个月后, 他被千叶县创伤性亚马病康复中心收治。入?...

Watch this Scientific Journal Video about Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury at JoVE.com

Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury

[18f] fdg 示踪剂在重型颅脑损伤患者中的半定量评价

[18f]-氟脱氧葡萄糖 (fdg) 正电子发射断层扫描断层扫描可用于研究与大脑功能相关的葡萄糖代谢。在这里, 我们提出了一个协议 [18f] fdg 示踪剂设置和半定量评估的目标大脑区域的利益区域分析与临床表现相关的严重创伤性脑损伤患者。

Patients with severe traumatic brain injury (sTBI) have difficulty knowing whether they are accurately expressing their thoughts and emotions because of ...

此列表可以帮助我们解决神经康复领域的关键问题。关于脑外伤脑损伤后无反应的觉醒综合症和最小的意识状态。该技术的主要优点是，脑组织变形的患者，如萎缩，肿胀，扩大和缩小心室空间，可以在慢性阶段得到帮助。演示这个程序的将是东木井田，我们的药剂师，Kazuaki横山，我们的熟练操作者，瑞穗Kaezawa，我们的护士，新治奥诺德拉和小崎义弘，来自我的实验室的放射技师。开始为 FDG 的自动化生产制造试剂套件，该试剂盒是针对使用的合成器量身定制的。将制造试剂盒的注射器设置为自动 FDG 合成器中的相应注射器驱动器。请务必使用自动程序检查泵送系统的机动性。检查氧气-16和18水的体积，以及氦气、氢气和氮气的体积。还要确保自来水在 25 摄氏度以下进行初级冷却，在二次冷却时低于 22 摄氏度。一小时后，确保空气不会从试剂盒泄漏。设置小瓶的醋酸酯，曼诺斯小三叶，乙醇和PH缓冲液。在回旋加速器中开始对氧-16进行初步辐照。检查目标区域的最佳条件下是否辐照了两到三毫升的水。接下来，开始90分钟后，在回旋加速器中开始对氧-18水的照射。将轰击时间设定为20分钟，将冲击质子的能量设定为16.5兆电子伏特。确保回旋加速器运行时灯亮起。辐照后，使用氦气将2至3毫升氧-18水从回旋加速器转移到FDG合成器的聚丙烯接收器。将注射器钩到相应的注射器驱动器和加压试剂小瓶上。然后，将曼诺斯特三叶酸溶解在一瓶99.5%的纯乙酰三叶酸中，然后用醋酸酯冲洗盒式。将辐照氧-18水转移到FDG合成器。然后，将洗涤剂转移到含氟-18中后，将无液体转移到反应容器中。让溶剂蒸发至干燥。在干燥过程中，在反应容器中三次加入80微升乙酰酸盐。在氮流和真空下在 95 摄氏度下进行蒸发。将25毫克三叶酸酯溶解在约3.5毫升的99.5%纯乙酰三叶酸中，然后加入干残留物。在FDG合成器中，在85摄氏度下发生嗜核替代反应。作为初步纯化，将标记溶液与26毫升蒸馏水混合。然后，将稀释标签溶液的四毫升送回反应容器，以恢复剩余活性。接下来，将解决方案通过反向相位墨盒。然后，使用蒸馏水冲洗含有受困标记的前体四次的墨盒。现在，通过碱性水解将乙酰化合物转化为盒内的FDG。在室温下使用 750 微升 2 N 氢氧化钠 90 秒。水解完成后，在70毫升水中收集碱性FDG溶液，并和中和溶液混合。然后，净化生成的中和 FDG 溶液。通过第二个反向相筒，保留部分水解化合物和非双极副产品，将中和 FDG 解决方案通过。然后，通过氧化铝-N墨盒，保留未反应的F-18粉离子的最后痕迹，然后通过0.22微米过滤器。接下来，用3毫升水冲洗盒和墨盒，过滤过滤器，以回收生产线中的残留FDG。然后，将FDG排入最终的小瓶中，其中应含有15至17毫升液体。从准备开始2小时30分钟后，通过检查小瓶来检查小瓶以确认其无颗粒是透明的，进行定性分析。此外，使用长袍测量液体量会旋转平衡。并使用放射性同位素剂量校准器测量放射性和半寿命。现在，使用试卷测量PH和残留的墓穴-22。此外，通过吸收度测量使用适当的设备测量内毒素。接下来，从小瓶中分配0.5毫升，通过碳水化合物分析进行放射化学纯度测试。使用 3.9 1 300 毫米的柱进行高性能液相色谱，以检测峰值放射性。最后，用FDG跟踪器填充铅和钨覆盖的小瓶，每公斤体重为5兆贝克勒。然后，在开始时间后 3 小时 25 分钟，将跟踪器从热实验室转移到工作间。首先为FDG追踪器给药准备静脉注射途径。用5毫升肝素钠固定一个22至24表针，放在下肢之一上。然后，患者应躺下 30 分钟，然后进入辐射控制区。接下来，通过抽血重新检查静脉注射路线的测量，并测量患者的血糖水平。然后，通过窗口将 FDG 跟踪器从热实验室转移到工作间。在自动点胶和喷射系统中设置跟踪器。从显示器上的小瓶检查 FDG 跟踪器的吸气。连接患者和自动分配注射系统之间的管子。推底，将 FDG 跟踪器注射到患者体内。此时，停止以确认跟踪器数量和批号、编程放射性、注射时间、注射速度和测量的放射性水平。现在，记录自动显示和喷射系统显示屏上显示的预注射放射性的自动测量。然后，在开始后3小时30分钟通过静脉注射途径注射追踪器。让患者在辐射控制区候诊室等候50分钟。然后，在开始时间后4小时30分钟，将患者从候诊室转移到PET/CT机，并记录大脑图像10分钟。成像后，检查注射区域有无外花。获得所有数据后，使用成像软件评估所有图像数据，进行标准化的吸收值测量，并将临床评估与 FDG-PET/CT 图像进行比较。此图显示了具有代表性的 FDG-PET/CT 大脑图像。此处显示的是三维图像浏览器中右三维葡萄糖代谢的测量。在这里，我们看到一个代表性的彩色映射图像后，FDG-PET和CT融合。扫描时的血糖水平描述为红色，SUV 最大阈值为 50%。此面板显示具有代表性的三维脑表面 FDG-PET 图像。红色区域的葡萄糖代谢比绿色区域高。扫描时血糖水平显示为红色。在尝试此程序时，重要的是根据患者人数调整轰炸时间和能量。此外，应注意加密-222管，因为它很容易被结晶停止。还要知道，注射器的挂钩应小心处理，因为它很容易被打破。此外，请注意，脑外伤患者有时会在图像采集过程中做出不可预见的运动。按照这个程序，添加在许多方面可以应用各种放射性测试，以回答涉及氨基酸代谢的其他问题。不要忘记，使用放射性物质可能非常危险，执行此程序时应始终采取辐射防护等预防措施。

Research

JoVE Journal

Medicine

Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury

Non-invasive Imaging of Acute Allograft Rejection after Rat Renal Transplantation Using 18F-FDG PET

Non-invasive Imaging of Acute Allograft Rejection after Rat Renal Transplantation Using 18F-FDG PET

大鼠肾移植后急性排斥反应的非侵入性的成像使用<sup&gt; 18</sup&gt; F-FDG PET

The number of patients with end-stage renal  disease, and the number of kidney allograft recipients continuously increases.  Episodes of acute cellular ...

科研

医学

A Contusion Model of Severe Spinal Cord Injury in Rats

挫伤模型脊髓严重损伤的保护作用

The translational potential of novel treatments should be investigated in severe spinal cord injury (SCI) contusion models. A detailed methodology is ...

Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment (RMCA) in Individuals with Chronic Spinal Cord Injury

Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury

评价呼吸肌慢性脊髓损伤个人使用呼吸电机控制评估（RMCA）

During breathing, activation of respiratory muscles is coordinated by integrated input from the brain, brainstem, and spinal cord. When this coordination ...

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic ...

Assessment of Vascular Function in Patients With Chronic Kidney Disease

血管功能在慢性肾脏疾病的评估

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

Non-invasive Imaging and Analysis of Cerebral Ischemia in Living Rats Using Positron Emission Tomography with 18F-FDG

Non-invasive Imaging and Analysis of Cerebral Ischemia in Living Rats Using Positron Emission Tomography with 18F-FDG

无创成像和脑缺血分析生活中的大鼠使用正电子发射断层扫描<sup&gt; 18</sup&gt; F-FDG

Stroke is the third leading cause of death among Americans 65 years of age or older1. The quality of life for patients who suffer from a stroke fails to ...

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

评价中的连接有关的大脑兴奋患者癫痫多式联运Imaging-和激励为基础的方法

Resting-state functional connectivity MRI (rs-fcMRI) is a technique that identifies connectivity between different brain regions based on correlations ...

Determining Glucose Metabolism Kinetics Using 18F-FDG Micro-PET/CT

Determining Glucose Metabolism Kinetics Using 18F-FDG Micro-PET/CT

确定葡萄糖代谢动力学研究<sup&gt; 18</sup&gt; F-FDG微PET / CT

This paper describes the use of 18F-FDG and micro-PET/CT imaging to determine in vivo glucose metabolism kinetics in mice (and is transferable to rats). ...

Severe Burn Injury in a Swine Model for Clinical Dressing Assessment

猪临床敷料评价模型中的严重烧伤

Wound healing is a dynamic repair process and is the most complex biological process in human life. In response to burn injury, alterations in biological ...

Whole Body and Regional Quantification of Active Human Brown Adipose Tissue Using 18F-FDG PET/CT

Whole Body and Regional Quantification of Active Human Brown Adipose Tissue Using 18F-FDG PET/CT

18F-fdg Petct 对活性人棕色脂肪组织的全身和区域定量

In endothermic animals, brown adipose tissue (BAT) is activated to produce heat for defending body temperature in response to cold. BAT&#39;s ability to ...